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Friday, August 24, 2012

Those folks who support President Obama's affordable care act because they believe it will help the poor get more and better medical care are, in the opinion of Avik Roy, in for yet another Obama-inspired disillusionment.

Obamacare is going to actually make it more difficult for the poor to get medical care. One should read Roy's entire piece to see why this is so, but the short version is that by reducing benefits to doctors in order to save costs, fewer physicians will be accepting Medicaid patients. It's the same problem, in fact, which looms over Medicare.

Here's Roy's intro:

The story of Deamonte Driver illustrates how our health-care the system leaves millions of Americans behind. Deamonte lived on wrong side of the tracks, in Prince George’s County, Md. He was raised by a single mother. He spent his childhood in and out of homeless shelters. He was an African-American kid on welfare. Deamonte died at age twelve — not, however, in a drive-by shooting, or in a drug deal gone bad. He died of a toothache.

In January 2007, Deamonte told his mother, Alyce, that he had a headache. She took him to the hospital, where he was diagnosed with a severe dental abscess and given some medication. But the next day, his condition worsened. It turned out that the infection from his tooth had spread to his brain. He was taken to the hospital again and underwent emergency surgery. After a second surgery, he got better for a while, but then began to have seizures. Several weeks later, Deamonte was dead.

According to [columnist] Ezra Klein, Deamonte Driver’s story shows us why it would be immoral to repeal Obamacare. “To repeal the bill without another solution for the Deamonte Drivers of the world? And to do it while barely mentioning them? We’re a better country than that. Or so I like to think.”

But Deamonte Driver died not because he was uninsured. Indeed, Deamonte Driver died because he was insured — by the government. Deamonte, it turns out, was on Medicaid.

Although Deamonte was insured, he never received routine dental care. It turns out that only 16 percent of Maryland dentists accept Medicaid patients. Fewer than one-sixth of Maryland kids on Medicaid have ever had a cavity filled. Deamonte’s younger brother, DaShawn, had six rotted teeth, but it took dozens of calls before DaShawn could find one dentist who would see him. When the dentist concluded that DaShawn’s teeth were beyond repair, and required extraction, it took another several months to find an oral surgeon who would see him.

Obamacare does not offer better health care to the Deamonte and DaShawn Drivers of the world. Under Obamacare, if Deamonte were alive today, he would still be stuck with the dysfunctional Medicaid coverage that he was stuck with before. In fact, according to the Congressional Budget Office, Obamacare will shove 17 million more Americans into Medicaid, the developed world’s worst health-care system.

There are many problems with Obamacare. But the law’s cruelest feature is what it will do to low-income Americans who are already struggling. Study after study shows that patients on Medicaid have far worse health outcomes than those with private insurance. The largest study of this type, conducted by the University of Virginia on nearly 1 million patients, found that surgical patients on Medicaid were 97 percent more likely to die in the hospital than those with private insurance, and 13 percent more likely to die than those with no insurance at all.

These results are not surprising. Medicaid pays doctors and hospitals, on average, about half of what private insurers pay. Most often, Medicaid pays less than what the care actually costs. As a result, doctors face the choice of caring for Medicaid patients — and going bankrupt — or shutting their doors to the poor and focusing instead on those with private insurance.

Of course, the government could demand that physicians take indigent patients, but making medical practice less lucrative would only result in fewer people going into medicine and more doctors leaving it. Nancy Pelosi said we have to pass Obamacare in order to see what's in it. Well, what's in it is trillions of dollars in costs and taxes for a system that will provide less quality and less care than the one we already have. What a deal.

Carol Brown describes how she, as a young liberal, once viewed conservatives - that is, until she became one:

Bill Whittle has nailed it. He has spoken the truth about how liberals view conservatives (skip to the 1:55 mark for this part). Liberals think that conservatives are:

Old

Stupid

Evil

Some of the above

All of the above

Indeed.

When I was a liberal, this was exactly the way I saw conservatives.

Let's start with Evil.

I would have a knee jerk reaction to any conservative assuming - knowing - they were rich, greedy, uncaring, selfish, and arrogant. Oh, and they liked to go to war just for the hell of it. In a word: Evil. I would not listen to conservatives talk on any issue because of my rock solid belief that they were horrible human beings who cared not a whit for others.

In this way, a feedback loop was created such that when a conservative would speak, I knew they were evil and felt no desire to listen. (Why get aggravated, right?) Or, if for some reason I was compelled to listen for a few minutes, every word that came out of their mouth was tainted with the awful truth that I knew. Yes, they were evil.

Follow the link to read the rest of how liberals view conservatives, or at least how Brown did. She has a follow-up piece here.

For my part, I have to agree with "Some of the above." Conservatives do tend to be older because wisdom is a gift rarely bestowed on the young, and, given the universal opprobrium heaped on Missouri senate candidate Todd Akin by conservatives in the wake of his infelicitous remarks about female physiology, I have to say that their reaction was certainly stupid.